A 30-year-old woman develops optic neuritis and spinal cord symptoms. MRI shows periventricular white matter plaques. Histology of a plaque shows perivenular demyelination with reactive astrocytes. Which cell type is primarily responsible for myelin destruction in this disease?
- A CD8+ T cells
- B CD4+ T cells
- C Macrophages ✓
- D B cells
Correct answer: C. Macrophages
Explanation
The disease is multiple sclerosis. While CD4+ T cells initiate the inflammatory response, macrophages are the effector cells that phagocytose and destroy myelin. CD8+ T cells and B cells also contribute, but the actual demyelination is executed by macrophages. Reactive astrocytes form the chronic plaque.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.